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Upper camptocormia in Parkinson's disease: Neurophysiological and imaging findings of both central and peripheral pathophysiological mechanisms.

Magrinelli, F; Geroin, C; Squintani, G; Gandolfi, M; Rizzo, G; Barillari, M; Vattemi, G; Morgante, F; Tinazzi, M (2020) Upper camptocormia in Parkinson's disease: Neurophysiological and imaging findings of both central and peripheral pathophysiological mechanisms. Parkinsonism Relat Disord, 71. pp. 28-34. ISSN 1873-5126 https://doi.org/10.1016/j.parkreldis.2020.01.004
SGUL Authors: Morgante, Francesca

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Abstract

BACKGROUND: Camptocormia is a disabling complication of Parkinson's disease (PD), but its pathophysiology is poorly elucidated. Depending on the fulcrum of forward trunk flexion, two subtypes have been defined, upper (UCC) and lower camptocormia, the former being much more frequent. The aim of the study was to explore possible pathophysiological mechanisms of PD-related UCC. METHODS: Ten PD patients with UCC (UCC-PD) and ten PD patients without camptocormia (NoUCC-PD) underwent simultaneous electromyography (EMG) of thoracic paraspinal (TPS), obliquus externus abdominis (OEA), rectus abdominis (RA), and iliopsoas (IP) muscles during relaxed standing (both groups) and trunk realignment (UCC-PD group). Quantitative EMG and magnetic resonance imaging (MRI) of TPS muscles were also performed. RESULTS: UCC-PD patients showed hyperactivity of TPS and OEA muscles in quiet stance. During voluntary trunk extension, hyperactivity of OEA muscles persisted, thus revealing a co-contraction of flexor and extensor trunk muscles. Motor unit potentials (MUP) of TPS muscles showed shorter duration (p = 0.005) and lower amplitude (p = 0.004) in UCC-PD than in NoUCC-PD patients. MRI did not detect significant between-group differences in the cross-sectional area and fat fraction of TPS muscles, although the latter was higher in the UCC-PD than in the NoUCC-PD group at all thoracic levels. CONCLUSION: Our findings suggest that hyperactivity of OEA might sustain UCC in PD. Concurrent mild myopathic changes in TPS muscles in PD with UCC may be secondary to muscle disuse but nevertheless may contribute to abnormal trunk posture.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Camptocormia, Electromyography, Magnetic resonance imaging, Parkinson's disease, Pathophysiology, Camptocormia, Electromyography, Magnetic resonance imaging, Parkinson's disease, Pathophysiology, 1103 Clinical Sciences, 1702 Cognitive Sciences, Neurology & Neurosurgery
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Parkinsonism Relat Disord
ISSN: 1873-5126
Language: eng
Dates:
DateEvent
February 2020Published
11 January 2020Published Online
10 January 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
2017Brain Research Foundationhttp://dx.doi.org/10.13039/100000882
PubMed ID: 31981996
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111633
Publisher's version: https://doi.org/10.1016/j.parkreldis.2020.01.004

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